multivitamins

A Hard-Working Multivitamin

Arlington Heights, Ill. (April 2016)
Although we try to get all of
the vitamins and minerals we
need from the foods we eat,
maintaining a healthy diet can
be a challenge due to work,
social, and at-home demands.
Men’s Omega Multi is specially
designed for men who want
to fill these nutritional gaps
and achieve optimal wellness.
Men’s Omega Multi provides
13 vitamins, nine minerals, the
omega-3s EPA and DHA, and six
other ingredients scientifically
shown to support heart, brain,
vision, joint, muscle, bone,
colon, prostate, and immune
system health.

“This unique formula is specially designed for men
and offers all of the important vitamins and minerals
they need, plus omega-3s,” says Carlson Labs President
Carilyn Anderson.

Men’s Omega Multi can be found at www.carlsonlabs.com or at a nearby health food store. For a hard-working multivitamin, choose Men’s Omega Multi.

About Carlson Labs
Since 1965, Carlson Labs has
produced the freshest, purest,
award-winning vitamins, minerals,
fish oils, and other nutritional
supplements. They launched at the
forefront of the industry, offering the
most complete line of natural-source
vitamin E products in the world.
They then paved the way for bringing
fish oil and cod liver oil to the U.S.
Market. In 2009, they launched
calamari marine oil, and today,
they’re proud to bring you a product
line of more than 200 innovative
formulas designed with your family’s unique nutritional
needs in mind. For more information, call (888) 234-5656,
check out their website at www.carlsonlabs.com, or visit
your local natural food store. J.R. Carlson Laboratories,
Inc. is located at 600 W. University Dr., Arlington Heights,
IL 60004.

Taking Supplementation Seriously Part II:

Last month, we started a dialogue on whether supplementation
is the appropriate course for insuring a nutritionally complete
diet. We examined a very simple case, the multivitamin:
a supplement designed to provide the base set of essential
nutrients that are requisite for normal human metabolism. In
response to the case against multivitamin usage (“proper diet
alone should be adequate in providing essential nutrients”),
we considered how 1) widespread deficiency of several nutrients
in the U.S. diet, 2) the demonstrated reduction in nutrient
availability in the modern food supply, and 3) the subclinical
deficiencies in several nutrients that can result from caloric
restriction and exercise, suggest that supplementation of essential
nutrients may be warranted in some individuals. Here
we expand the list of observations to consider when making
the decision whether to include a multivitamin in your daily
health regimen.

Taking Supplementation Seriously Part I:

There is an ongoing debate on whether dietary supplements deserve to be part of a health-promoting strategy. Several medical organizations do not advise routine supplementation for people, without underlying deficiencies, citing safety concerns or lack of clear evidence of benefits, and suggest that an adequate diet should be sufficient in obtaining proper nutrition. Prophylactic use of supplemental vitamins or minerals, like iron, has sparked controversy. On the other hand, there is a wealth of published, peer-reviewed scientific data that present strong correlations between adequate nutrient intake and lowered disease risk/incidence, as well as studies in which nutrient interventions demonstrated significant health benefits. Hyperbolic media reports that “resveratrol may make you live longer” or “multivitamins may cause prostate cancer” further complicate the dialog.

This article is the third in the series begun with “Solving
the Mystery of the Multivitamin” and continued with “The Special
Nutritional Needs of Women.” Here it is observed again
you do not need to believe “men are from Mars, women are
from Venus” in order to accept that men and women have
different nutritional needs. Men lead in eight of the top ten
causes of death in the United States. As it is often remarked,
because men are more reluctant than women to seek medical
care, when they do so, their illnesses typically have advanced
to a more serious degree. It would seem that men, even more
than women, would do well to adopt defensive measures to
preserve their health. However, men should not depend on
the supplements used by their wives or women friends. Some
preventative measures are strictly gender-specific. The following
suggestions are designed to help men take charge of their
health while the ball is still in their court.

This article is the fourth in the series that began with “Solving the Mystery of the Multivitamin.” The focus now shifts to reasons for taking a multivitamin/mineral as we enter the second half of life and, more importantly, the overall approach to nutrition that should inform any anti-aging program. Readers will discover that some, but not all of the gender-specific nutritionaln needs covered in earlier articles become less meaningful in later life. As individuals approach 60, overall physiology changes in ways that tend to lead to a convergence of nutritional requirements.

There is a vitamin revolution brewing, and it is important to the health of young and old alike as researchers respond to what has been called the “vitamin D deficiency epidemic.” More than a dozen scientists at leading universities both in the United States and abroad have minced no words about it: many of us need more vitamin D. (See “Cod liver oil, vitamin A toxicity, frequent respiratory infections, and the vitamin D deficiency epidemic.”)1 The issue of deficiency may be especially true of children, yet it is also applicable to adults. Quite surprisingly as far as vitamin D is concerned, the suggested intakes in recent decades have fallen rather wide of the mark. Not only are the recommendations of 400 IU/day as an adequate intake (100 percent of U.S. Daily Value) and 2,000 IU/day as an upper limit too low, but also recommendations may have been more realistic 70 years ago. As detailed below, in a tale of two vitamins, A and D, scientists initially bet on the wrong one.

Vitamin D Versus Viral Respiratory Infections
All the way back in 1926, it was theorized that a disorder in vitamin metabolism linked to a lack of sun exposure is responsible for the rise in infections experienced during the winter months.2 Experiments in the 1930s provided considerable support for this hypothesis. Using a cod liver oil much higher in vitamin D content than is typical today, one large trial involving 185 adults for four months discovered that supplementation reduced the rate of infections with colds by 50 percent.3 Another study tracking 1,561 adults found the rate of respiratory infections fell by 30 percent.4 Recent work comparing 410 teenage athletes who received vitamin-D producing radiation against 446 athletes who did not over a period of three years demonstrated the same range of benefits as was seen with cod liver oil supplementation in the 1930s: 50 percent fewer respiratory infections and 300 percent fewer lost days due to absences.5

How does vitamin D provide protection against infections? This has been the subject of considerable work and the answer seems to be vitamin D produced in the skin in response to sunlight provides the body with the vitamin in its hormonal form known as 1,25(OH)2D, actually a type of steroid hormone. Indeed, the skin has the capacity to synthesize the biologically active vitamin D metabolite 1,25(OH)(2)D3.6 The active form of vitamin D serves both to reduce the excessive production of inflammatory factors and, yet, to increase the power of other immune elements, such as the “oxidative burst” of the macrophages, the immune system’s first line of defense. The effects of the vitamin on the immune system are particularly striking in an area that touches directly on defenses against colds and respiratory infections/flu. The lining of the respiratory tract is full of neutrophils, monocytes and natural killer cells, all of which contain anti-microbial peptides that are empowered by vitamin D.7

These benefits are known for sun exposure. Great news for the summer months, but can the use of vitamin D supplements help to provide the same protection? Luckily, the answer is “yes.” In a randomized placebo-controlled intervention trial lasting three years, it was discovered African American women receiving vitamin D exhibited only one third the likelihood of reporting cold or flu symptoms as did controls. The amount of vitamin D needed to abolish completely the tendency towards more colds and flu in the winter months was only 800 IU/day. Increasing the intake of supplemental vitamin D to 2,000 IU/day almost entirely eliminated reports of upper respiratory tract infections.8

Vitamin D and Vitamin A: A Conflicted Relationship
Recent studies using cod liver oil have not produced as robust a response in preventing infections as those found in the 1930s. Why not? The answer appears to be tied to the tendency over the last few decades to overrate the importance of vitamin A and to underrate the importance of vitamin D. Cod liver oil-based studies in recent years have used supplements typically providing 3,500 to 5,000 IU vitamin A as preformed retinol and only in the neighborhood of 700 IU vitamin D. The problem in this is vitamin A and vitamin D competes against one another because they make use of common cofactors. Vitamin A acts as an antagonist to vitamin D and its active metabolite.

That there might be an untoward interaction between vitamin A and vitamin D has been suspected for quite some time. Research at several laboratories has confirmed this suspicion. In an animal study, it was found there is an in vivo antagonism of vitamin D action on intestine and bone by retinyl acetate.9 Exactly how vitamin A antagonizes vitamin D is not entirely clear, but the fact is being ever more soundly established.10 Moreover, in human beings the amount of vitamin A needed to interfere with aspects of vitamin D metabolism is not high. For instance, one serving of liver as a vitamin A source interferes with vitamin D’s effects on the intestinal response to calcium.11 Many Americans are marginal or outright deficient in vitamin D. In such cases, the amount of vitamin A supplied by multi-vitamins and other sources is sufficient to tip matters over the edge into significant manifestations, such as reduced bone health.12 Although vitamin A deficiency is a serious issue in parts of the developing world, predominantly due to a lack of adequate fat in diet impeding absorption of this fat-soluble vitamin, once vitamin A requirements are met, there is a significant negative interaction with vitamin D.

Cardiovascular Health and the Sunshine Vitamin
The role of vitamin D in cardiovascular health is one of the currently “hot” topics in research circles, and for good reason. Vitamin D levels have been linked to a number of aspects of heart and circulatory health. Take blood pressure, for instance. It generally is assumed that blood pressure, primarily systolic blood pressure (the upper figure), increases naturally with age. This is the reason the elevation over time is named “age-associated increase in systolic blood pressure.” Interestingly, maintaining “optimal” vitamin D status reduces or attenuates the elevation in blood pressure that is expected with age.13 Another circulatory condition, lower-extremity peripheral arterial disease, similarly is related to vitamin D status. Nearly one third of the higher prevalence of this condition in adult blacks compared to whites is explainable by vitamin D levels being lower in blacks.14

Another way of thinking about vitamin D and cardiovascular health is to consider the lively discussions ongoing in research circles regarding the relationship of statins and vitamin D. Cardiovascular disease has a large inflammatory component and some scientists have argued that statins act, in large part, by serving as vitamin D analogs. Moreover, another aspect of cardiovascular disease concerns vascular calcification and statins recently have begun to be touted for bone health as well as reducing calcification of the arteries.

As is true of many substances, vitamin D is biphasic in some of its actions. Too much is a bad thing, but too little can lead to some of the same results as too much. Above it was mentioned that the vitamin plays a role in reducing inflammation. This is significant to heart health because arterial inflammation is an important step in the process leading to calcification. Hence, it is of note that in an animal model, low levels of the vitamin D hormone calcitriol are associated with massive vascular and soft tissue calcifications.15 That’s right: low levels of vitamin D-related compounds may lead to vascular and soft tissue calcification. Findings are interesting enough that researchers have begun to discuss vitamin D in the prevention and treatment of coronary heart disease.16

So what about statins and vitamin D? Much evidence available for over a decade suggests that statin drugs are cardio-protective via anti-inflammatory effects on the artery wall and not through any impact on cholesterol levels. Hence it is of note that treatment with statins, at least over the short and medium term, increases serum vitamin D by an unknown mechanism.17 At the same time, vitamin D deficiency, which is quite common in those with cardiovascular problems, appears to play a role in the myalgia associated with statin use.18

In other words, at least some of the benefits attributed to statin drugs, whether cardiovascular or bone-related, appear to be linked to improved vitamin D status. Likewise, at least one of the side effects of statin usage is linked to vitamin D deficiency.

Guarding Cognitive Health
Poor mood often is associated with advancing years. Recent data suggests that poor vitamin D status may be common in the elderly and low levels of vitamin D are associated with poor mood. There are a number of trials that have suggested a role for supplementary vitamin D in the treatment of depression.19
The impact of vitamin D status, however, appears to go far beyond merely improving mood. A large trial involving 1,766 adults over the age of 65 identified vitamin D levels as related to cognitive function and dementia. The relationship is strong enough that the researchers suggested supplementation with vitamin D as a possible way to reduce the risk of developing dementia.20

How Much is Enough?
As usual, the devil is in the details. How much vitamin D is enough? Quite obviously, there likely is a range and not any one figure involved. People are different, get different amounts of sun exposure, have different diets, different stresses, and so forth. One recent study argues that the amount of vitamin D intake needed to attain the desired serum 25-hydroxyvitamin D concentration may run between 3,800 and 5,000 IU per day, amounts in excess of the currently officially endorsed upper limit of intake.21 These amounts are based on the researchers’ estimate of the intake of vitamin D3 needed to raise serum 25(OH)D to equal to or greater than 75 nmol/L and is in line with long-time recommendations of many experts of 3,000 to 5,000 IU/day.22 Other researchers using a different model of sun exposure and intake from food while restricting themselves to the requirements of Caucasians only still determined that a reasonable level of intake to prevent seasonal fluctuations may be as much as approximately 1,600 IU/day.23 Again, this is a far cry from the presently recommended 400 IU/day. Moreover, some individuals have low vitamin D status even with abundant sun exposure.24 All of this suggests the recommendation for vitamin D intake may soon be revised strongly upwards and that the currently suggested upper limit of intake of 2,000 IU/day may, instead, become closer to baseline.

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